DIRECT TO CUSTOMER ALIGNERS – A Threat to the Public’s Dental Health

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DIRECT TO CUSTOMER ALIGNERS – A Threat to the Public’s Dental Health

Aligners are a device that has been used by Orthodontists to treat irregular teeth and other tooth position problems since the early 2000s. They are clear plastic trays that are manufactured to fit snugly on the teeth. They are programmed to bring about tooth movements that the orthodontist desires.

Aligners previously were delivered by domain experts – ORTHODONTISTS who underwent a 3-year specialist training program after a basic five-year dental training. This enabled them to diagnose and treat MALOCCLUSION – the problem of tooth position. They treated cases to high standards and prioritized gum health and joint health in the process.

Now we have the spurt of companies that promise to deliver aligners to the patient’s home and bypass the orthodontist. Let us refer to them as D2C aligners. This poses a grave threat to the dental health of these patients.

The two main reasons are as follows:


The diagnosis of a case that requires orthodontics must be very personalized and accurate. Aligner companies outsource diagnosis and record collection – sometimes they even advise patients to take their own moulds or IMPRESSIONS (specialized procedure which requires training and practice to be accurate and is done only by dentists).

The diagnosis is of the assembly line variety and trivializes attention to dental health and precision in evaluating the problem that orthodontists value.

A wrong diagnosis can result in shoddy outcomes that might result in poor dental fit (OCCLUSION) of the teeth.

While the patients might be happy in the short term with the outcome, unknown to them a poorly designed D2C aligner might compromise their DENTAL OCCLUSION leaving them prone to jaw joint issues in the future.

The companies have non-disclosure agreements that do not allow patients to complain if they are unhappy with the treatment. That is where the problem is: D2C aligners are marketed by CORPORATES who prioritize profits as opposed to an ORTHODONTIST who values his reputation and the treatment outcome for his patients.


Corporates always paint a rosy picture in the pursuit of profits and customer numbers. They never inform a patient that an aligner has some drawbacks and CERTAIN MALOCCLUSIONS REQUIRE TRADITIONAL FIXED APPLIANCES OR BRACES.

Poorly designed aligner Pain

An aligner has limitations which might not permit its use in all cases. In case you have severe malocclusion, your orthodontist might advise Traditional FIXED ORTHODONTICS or braces.

ALIGNER COMPANIES PAINT BRACES as a primitive painful device. This is far from the truth – fixed appliances use extremely sophisticated and advanced materials, and it still happens to the GOLD STANDARD as far as control and precision in tooth movement are concerned.


In conclusion, the D2C aligner companies are profit-driven. No one says that profit is bad. But the way profits are generated with a very cavalier approach to diagnosis and treatment planning is disturbing.

These appliances are being positioned as A REPLACEMENT FOR HIGH-QUALITY PERSONALIZED ORTHODONTICS. This is misinformation to the trusting masses. A one-size-fits-all approach is a SUREFIRE RECIPE FOR COSTLY RETREATMENT in many which will strain the finances of trusting patients.

Traditional fixed appliance (Braces)

A holistic approach that an orthodontist employs with in-depth analysis of the problem using multiple diagnostic inputs, his versatility in appliance selection and THE EXPERT USE OF APPLIANCES WHETHER HIGH-QUALITY ALIGNERS OR HIGH-QUALITY FIXED APPLIANCES to treat cases to world-class standards is what this country must aspire for.

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